My baby was in the NICU for four days, and I had a difficult time getting her to breastfeed for the first two or three weeks. She is now going to be 4 months on January 6 and I thought we were doing great with breastfeeding. She was gaining about 4 oz a week and last visit she gained only 3.25 oz a week. her pediatrician says she needs to gain more weight and he says that if she hasn't gained more weight next time we have to add formula. I really don't want to, but I don't want her to be unhealthy either. She is a tall baby, last visit in the 90ish percentile for length and 30 ish for weight. She used to be in the 50ish for weight though. She weighed 11.5 lbs about a week ago and our next appt is Jan 30. I tried pumping and giving her expressed milk, but she only took an ounce. She does spit up a lot, so at pedi's suggestion I gave her some rice cereal a couple of times, about three teaspoons. She hates it. I offer her the breast often and most of the time she only feeds from one, although at night she does finish one and take the other one. What can I do to help her gain weight, or is her weight ok? Thanks!

I would get a second opinion. DS1 also had a hard time gaining weight. He was born at 9lbs 7.3oz and had so much trouble nursing that I just decided to pump and bottle feed him expressed milk. He would always eat a ton, even more than the recommended amount. He had horrible acid reflux that we fought to keep under control. His height was usually in the 95th or above percentile but his weight was always around the 25th. The doctor was fine with his measurements and never told me to give him formula. He is 3.5 now and a tall, skinny beanpole. It is just his natural build. I don't really have any advice on how to get her to gain more weight but just wanted to let you know my experience.

Thank you for your responses. My baby has horrible acid reflux too, although it's getting better. For a while the reflux would make her gag and she would throw up everything she had just eaten, it would even come out her nose. This went on for at least three weeks. I think that might be affecting her weight gain. I'm pretty sure she's getting enough because I feed her and keep offering the breast to her until she refuses it. She also nurses a couple of times at night still. I feel better after reading these responses, thanks.

I was told that 1/2 an oz of weight gain per day is healthy for a newborn...that sounds like close to what shes gaining...I also would get a second opinion if you are not comfortable supplementing with formula. It seems rather unnecessary if she eats at least 8 times a day. I would have to wake DD to eat when she was a newborn. Do you wake her every 2 1/2-3 hours from beginning of one feeding to beginning of the next? This is what was recommended to me. I would also consider contacting a leader of La Leche League if you would like more advice and support...those ladies are awesome!

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SAHM to little A 1/12/12 and S 10/5/13 .. and playing music with lots of good stuff in between!!!!!

Thank you for your responses. My baby has horrible acid reflux too, although it's getting better. For a while the reflux would make her gag and she would throw up everything she had just eaten, it would even come out her nose. This went on for at least three weeks. I think that might be affecting her weight gain. I'm pretty sure she's getting enough because I feed her and keep offering the breast to her until she refuses it. She also nurses a couple of times at night still. I feel better after reading these responses, thanks.

Reflux definitely affects weight gain. If she's eating until she's full, she won't take additional formula. The only other thing I can think of is to make sure you are eating plenty of calories and not restricting your fat intake so that your milk is as calorie dense as possible. I second the pp suggestion to get a second opinion if your ped pushes formula supplementation.

Willowmom, she has eaten at least every 2-3 hours since she was a newborn, although recently she sleeps one 4 hour stretch at night. I will track her feedings to make sure she's eating at least 8 times a day, but I am 99% sure it's more than that. I have been thinking about going to a La Leche meeting since the last Dr. appt. I think I will. I am guessing the pedi is concerned since there's such a difference in her length and weight percentiles, and I can't help but worry. Thanks ladies, for all your responses.

Reflux can result in severe deficiencies and low weight gain. Is she medicated for reflux? Have you considered an elimination diet. Every case of reflux I have known has been helped by eliminating certain foods from the mom's diet. Only you know whether the effort is worth it to you, but finding her food sensitivities WILL help.

you dont HAVE to do anything a dr can suggest a treatment, doesnt mean you have to follow it. percentiles imo are crap and most dr's dont understand BF baby growth patterns. if she's nursing, gaining, eliminating there is absolutely no reason to supplement, esp since formula actually has LESS calories than BM